‘

- a accumulated with excessive mucus

- Causes of asthma: Allergens, stress, weather, excessive exercises, chemicals, medications, viral infections
- COPD patients: Pursed lip breathing to inhale more air, upright position for better lung expansion
Anatomical changes, patients with COPD
- Barrel chest= because of overinflation of the lungs in copd patients
- Clubbing of the fingers

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- 4 stages: mild moderate severe
- Mild: unnoticed symptoms, like allergies and colds only (simple symptoms) 80% lung capacity
- Moderate: there is persistent symptoms, previous symptoms worsens. Trouble sleeping, wheezing, increase mucus, this is because the lungs is working harder. 50-79%
of lung capacity
- Severe: 30-49% lung capacity. Worst symptoms. Respiratory infection. Morning head aches. Edema. Cannot breathe deeply = that’s why patients do purse lips breathing.
Cyanosis. Tachycardia. Changes in level of consciousness
- Very severe: 20-40% lung capacity. end stage of copd. Near death. Sudden weight loss. Exacerbation. Frequent admission to hospital. Normal tasks are difficult to
execute ex: walking, eating. Chronic respiratory failure = barrel chest. Chest pain, depression

- Most severe type of copd

- Pink puffers: emphysema. Blue bloaters: chronic bronchitis, bc of poor oxygenated blood = cyanosis
 - To measure the functional status of patients with copd

Nursing diagnosis for copd:

- Ineffective airway clearance r to excessive secretions

 - Impaired gas exchange r to activity intolerance
- Anxiety
- Powerlessness
- Risk for ineffective therapeutic management

Diagnostic examinations:

- Non invasive: take chest xray, sputum exam, o2 sat

- Invasive: abg level, pleural fluid analysis, thoracostomy

Planning

- Position the patient: high back rest

- Give oxygen by mask/ venturi mask: safest amount 1-2L because their drive to breath is depressed, it will just cause respi arrest
- Refer to Respiratory therapist
- Pt education: avoid smoking, excessive alcohol, avoid air pollutants
- Liquification of the mucous: medications like mucomist
- Expectorant, antitussive
Implementation
- Give antitussive at night to prevent sleeping disturbances
 Oxygen therapy
 Medical interventions (non invasive) 
 Pharmacologic: expectorant, antitussive, steroidal drugs (adverse
effect: moon face, brittle bones) give nsaids
 Small frequent feedings
 High caloric diet

menta
tion

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 FRACTURES = Risk for pulmonary embolism

I
Poor
Hygienic
measures
Change the ETT from time to time to prevent necrosis of trachea